New rule helps evaluate miners’ digital chest radiographs
From the Director’s Desk
by John Howard, M.D., director of the National Institute for Occupational Safety and Health (NIOSH)
Since its creation, NIOSH has been responsible by law for administering a program that offers chest radiographs, or x-rays, to provide underground coal miners with medical monitoring for coal workers’ pneumoconiosis, or "black lung," the term by which this serious but preventable occupational lung disease is probably better known among the general public. The NIOSH Coal Workers’ Health Surveillance Program (CWHSP) evaluates miners’ chest radiographs for the presence and severity of changes in the lung associated with coal workers’ pneumoconiosis. The program uses a standardized classification system developed by the International Labour Office (ILO).
Until recently, the ILO system could only be applied to traditional film radiographs, because it required the use of film-based radiography, the only radiography technology that existed years ago when the technical standard was developed. As a result, the system (and critically for our agency, the NIOSH program based on the system) could not be applied to the modern, digital chest images, which have largely replaced film-based radiographs at medical facilities in the United States. Digital imaging has largely replaced film methods because of its many advantages: It eliminates the need to develop film. It allows the electronic images to be stored and used economically like other computer files. It allows images to be adjusted to improve visualization of abnormalities and to compensate for problems like over-exposure of the image.